Specific compounds known to have antifolate activity are well known as chemotherapeutic agents for cancer treatment. U.S. Pat. No. 5,344,932 discloses processes for preparing certain substituted pyrrolo[2,3-d]pyrimidin-based antifolate derivatives, including pemetrexed, and European Patent Publication No. 0434426 discloses a series of 4-hydroxypyrrolo[2,3-d]pyrimidine-L-glutamic acid derivatives.
Pemetrexed, a 5-substituted pyrrolo[2,3-d]pyrimidine, is a multitargeted antifolate that exhibits anticancer effects against various cancers, including non-small cell lung cancer, by inhibiting the activity of metabolites that are involved in folate metabolism.
It is known that pemetrexed enters cells through the reduced folate carrier (RFC) that is a major folate transport system, and is then activated by folylpolyglutamate synthetase (FPGS) to form polyglutamate derivatives that target thymidylate synthase (TS) and dihydrofolate reductase (DHFR).
Currently, pemetrexed is marketed under the trade name of Alimta and is used as an agent for treating malignant pleural mesothelioma and non-small cell lung cancer (see Physicians' Desk Reference, 60th ed., pp. 1722-1728 (2006)). Alimta is sold in a lyophilized formulation that has to be reconstituted before administration. Specifically, Alimta is sold in a lyophilized powder formulation (100 mg or 500 mg) that needs to be reconstituted with 0.9% sodium chloride solution and finally diluted with 0.9% sodium chloride solution to a final concentration of 0.25 mg/ml, before administration to a patient.
Lyophilized powder formulations are complicated to prepare, and processes for preparing these formulations are very expensive. In addition, lyophilized formulations have the risk of being contaminated with microorganisms upon reconstitution, and pharmacists, physicians, nurses and the like who are involved in the preparation of medicines comprising these formulations are highly likely to be exposed to cell-destroying substances. Thus, in the case of cytotoxic anticancer agents such as pemetrexed, it is required to develop ready-to-use liquid formulations that can be stored for a long period of time, rather than developing lyophilized formulations.
In many cases, the problem of liquid formulations is instability during storage. Due to this instability, a large number of injectable formulations are used in the form of lyophilized formulations that are dissolved immediately before injection. Even in the case of pemetrexed or a pharmaceutically acceptable salt thereof, which has recently been provided in the form of lyophilized formulations, preparation as an aqueous solution formulation causes problems of unknown impurities increased when stored at room temperature for a long period of time. That is, this aqueous solution formulation suffers from a stability problem. Due to this stability problem, pemetrexed or a pharmaceutically acceptable salt thereof is currently used in the form of lyophilized formations in clinical applications.
To overcome the above-described shortcomings, some formulations have been proposed. For example, U.S. Pat. No. 6,686,365 (corresponding to Korean Patent Publication No. 2002-0081293) discloses a stable liquid formulation of pemetrexed, which comprises a therapeutically effective amount of pemetrexed, an effective amount of an antioxidant and a pharmaceutically acceptable excipient, wherein the antioxidant is selected from the group consisting of monothioglycerol, L-cysteine and thioglycolic acid.
However, with respect to the problem of the formulation disclosed in the above patent, it was reported that, when the formulation was stored at 25° C. for a long period of time, precipitation occurred, suggesting that the long-term stability of the formulation for a desired period cannot be guaranteed (PCT International Patent Publication No. WO 2012/015810). No liquid pemetrexed formulation stable for long-term storage has been experimentally or commercially realized so far. In fact, the present inventors prepared a pemetrexed-containing liquid formulation using the above-mentioned antioxidant L-cysteine and performed a stability test for the prepared formulation, only to observe several problems, including a change in the appearance, such as discoloration, an increase in impurities, and a decrease in the pH, after 2 weeks under stress testing conditions. In addition, the present inventors prepared pemetrexed-containing liquid formulations using about 60 kinds of stabilizers, including ascorbic acid, sodium thiosulfate, butylated hydroxyanisole, propyl gallate, EDTA, L-methionine, and acetyl cysteine, but these formulations all had insufficient stability.